How much rates vary
Facilitymedian $4,571 · 10th to 90th $501 to $7,244Professionalmedian $1,585 · 10th to 90th $933 to $2,042
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $6,918.31 | Facility | None | $1,548.82 | $1,584.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,584.89 | $1,659.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,570.88 Median $4,677.35 Typical High $8,128.31 | Facility | None | $4,570.88 | $4,677.35 | $8,128.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $316.23 Median $1,513.56 Typical High $1,584.89 | Professional | None | $316.23 | $1,513.56 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $1,778.28 | Professional | None | $870.96 | $1,513.56 | $1,778.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,513.56 Median $4,073.80 Typical High $4,897.79 | Facility | None | $1,513.56 | $4,073.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,548.82 | $1,995.26 |
Priority Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,778.28 | Professional | None | $831.76 | $1,122.02 | $1,778.28 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,905.46 | $2,137.96 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $616.60 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $316.23 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $1,122.02 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $776.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $295.12 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,148.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $154.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,071.52 |
Where Michigan sits
The same service costs 4.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 28th of 51
$1,585
AK $4,467TX $933
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.